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Home My WebLink About0112 LIETRIM CIRCLE w, yRr v S tf r >„ ,t 19 d j i�V � iX . /`d�4 i! 't:r�•t��*f�,tfi,y7rs��",. ' s,JA�j t Ca � Kr t��i, 'I' w:* 5, � f•C� �c• ,.. i .a.• '4I. 4 .!t � s,' �r,:�� s.! r �. e� v rq{... •p9l'.'""'t d e;" Vr9':�•:R r.t�l.q, .r,i* 1 ' r � S[F�i.�. �r `y. ti• eh,.�� _ - ,:,;,,.��iN•._.'!�.�'@ �ffZ,J u4y..t;�. +Yr P � p• �-.ter.,,ym.-.�.�•.iiFw=�.�_,.3..��--*kre.- .P.'�F ly: n t tS• �/y� i ' Rs r ..er,!h_S(�ri f!' �:w._ _ v _�-.._-tss: �=.,,r,,'-`-�• .:_aS.� Y! aSt 10 t M.� ��a�C4J ' n c 1 +rrt 's lA ��15 fJ 'C; , - ir o�•, a. ' � r�'• �ry id Fx� � �y��fJ1 Y��P,dR',��;`R;ix �..,.,,�K�,tt�VY}l�,p� �,i >y Y�j• ��SY�,r��1 yr a �t��,,,i ;,�R��J,. �<.m..� *�?,�..�:�'��stY.,�•�'"�+4¢�;,rFgt.'� YI�=`ol ��} .%��1,�'�11,��'3, '�',,;�.. S its p n 1 o i 41- 6 7 Town of Barnstable *Permit# " �-7 -�� ILIExpires 6 fnout/rs frorn issue date uY Regulatory Services Fee sARtvAM p �. Richard.V.Scali,Directo �� O Building Division Tom Perry,CBO,Building ommissiAedt o5 2 ` 200 Main Street,Hyannisl� 4 �0 D�l www.town.barnstable.ma.us 8ARN Office: 508-862-4038 5IABt x: 508-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY 169 1 0 g 6 Not Valid without Red X-Press Imprint Map/parcel Number Property Address r 1 -R L i z` -r?i N C i R c 1 e, YResidential Value of Work$ 150 d a 00 Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address y l 2 Lied✓i M e bet e PA14-e✓t/o!%1 1Y,1 0 2 6 3 y Contractor's Name ,!>7f11 l Sfymi-lel Telephone Number C4p6'2ai 14pdre, i n?lfoi/e�i'��/f�yc � G07Llf7 2dt�c-f 2 C�picai Home Improvement Contractor License#(if applicable) Email: Construction Supervisor's.License#(if applicable) e, 5 0 k Y I-17 Wworkman's Compensation Insurance Check one: ❑ I am a sole proprietor ❑ I am the Homeowner I have Worker's Compensation Insurance Insurance Company Name Am A -K I) '�r 0 s U P AA) C e CO . Workman's Comp.Policy# ;L WC S' a7 aL d d Copy of Insurance Compliance Certificate must accompany each permit. Permit Req st(check box) Q Re-roof(hurricane nailed)(stripping old shingles) AI j construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: .Property Owner must sign Property Owner Letter of Permission. A copy of the home Improvement Contractors License c&Construction Supervisors License is required. SIGNATURE: C:\Users\Decollik\AppD \Local\MicrosoR\Windows\Temporary Internet Files\Content.0utlook\2PIOIDHR\ XPRESS.doc Revised 040215 1. Page 7 of 7 Capizzi Home Improvement Inc. Specifications and Estimates STATE OF MASSACHUSETTS LETTER OF AUTHORIZATION TO APPLY FOR A BUILDING PERMIT UWE, fli,$r = , OWN THE PROPERTY LOCATED AT IN &V" MASSACHUSETTS. I HAVE AUTHORIZED CAPIZZI HOME IMPROVEMENT TO ACT AS MY AGENT TO APPLY FOR A BUILDING PERMIT IN ACCORDANCE WITH 780 CMR THE MASSACHUSET TS STATE BUILDING CODE. I GIVE MY PERMISSION TO LESSEE TO APPLY FOR A.BUILDING PERMIT IN ACCORDANCE WITH 780 CMR, THE MASSACHUSETTS STATE BUILDING CODE. SIGNATURE OF OWNER:, OWNER'S ADDRESS: OWNER'S TELEPHONE: LESSEE'S SIGNATURE: LESSEE'S ADDRESS: LESSEE'S TELEPHONE: APLLICANT'S SIGNATURE: APPLICANT'S ADDRESS: 1645 Newtown Rd., Cotuit, MA 02635 APPLICANT'S TELEPHONE: 508-428-9518 RESPONSIBLE OFFICER: RESPONSIBLE OFFICER ADDRESS: RESPONSIBLE OFFICER TELEPHONE: MassacchUsetts Department of Public safetyrJ/re x�,n�1t»er..�t�eerrlllr t- n: Soard'of Building Regulations and s$andardi `"-=��ffsce of Consumer Affairs&Business itegulaiioi ' i_icense: OS-064897 - t� jOMEIMPROVEMENTCONTRACTOR Construction Supervisor k �� Registration: 100740 4,. .. Typ Expiration:IOHN T STRUAASk(I Exp ;Y 6/23/2018 Supplemen 18 ALDEN AVE t` CAPIZZI HOME IMPROVEMENT,INC. iUZZARDS 13AY MA 02632 JOHN STRUMSKI �.CU tv(oil 1645 Natoutwi Rd. COtult,MA 02635 �— �� Undersecretary Commissioner expiration: 06/18/2018. :ss 9=35,000 Cubic aa-(991M�)of space. sssess a currenit edition of the Mssachusetts 9 Code is cause for r evoca tan of this license. ing infol-nauon v1src: ��.r mmass.60VI PS License or registration valid for individual use only before the expiration elate. If found return too ®ice of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 Boston,lA 02116 d Not valid without signature AC R i CERTIFICATE OF LIABILITY INSURANCE °ATE`MM/°°'m") 1 2/3 012 01 6 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME; Rogers and Gray Processing FAX ROGERS&GRAY INSURANCE AGENCY INC PH-fA/CNN EM. 508)398-7980 ,C No): ADDRESS: mail@rogersgray.com 434 ROUTE 134 INSURERS AFFORDING COVERAGE NAIC# SOUTH DENNIS MA 02660 INSURERA: AMGUARD INSURANCE CO 42390 INSURED INSURER B: CAPIZZI HOME IMPROVEMENT INC INSURERC: INSURER D: 1645 NEWTOWN ROAD INSURERE: COTUIT MA 02635 1 INSURER F: COVERAGES CERTIFICATE NUMBER: 114654 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE INSD WVD POLICYNUMBER MM/DDY/YYYY MM LTR I DIIYYYY LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAOE To CLAIMS-MADE OCCUR PREM SES Ea occu RENTED nce $ MED EXP(Any oneperson) $ N/A PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ POLICY❑JECTPRO ❑LOC PRODUCTS-COMP/OP AGG $ PRO- OTHER: I $ AUTOMOBILE LIABILITY - COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED N/A BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR HCLAIMS-MADE N/A AGGREGATE $ DIED I I RETENTION$ 1 1 $ WORKERS COMPENSATION X PER STATUTE OERH AND EMPLOYERS'LIABILITY ANYPROPRIETOR/PARTNEP/EXECUTIVE YIN E.L.EACH ACCIDENT $ 1,000,000 A OFFICER/MEMBEREXCLUDED? NIA1 NIA N/A R2WC775326 - 12/25/2016 12/25/2017 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below - E.L.DISEASE-POLICY LIMIT $ 1,000,000 N/A DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Workers'Compensation benefits will be paid to Massachusetts employees only.Pursuant to Endorsement WC 20 03 06 B,no authorization is given to pay claims for benefits to employees in states other than Massachusetts if the insured hires,or has hired those employees outside of Massachusetts. This certificate of insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy precedes the issue date of this certificate of insurance). The status of this coverage can be monitored daily by accessing the Proof of Coverage-Coverage Verification Search tool at www.mass.gov/lwd/workers-compensation/investigations/. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Town Of Barnstable ACCORDANCE WITH THE POLICY PROVISIONS. 200 Main Street AUTHORIZED REPRESENTATIVE Hyannis MA 02601 Daniel .Crcyey,CPCU,Vice President—Residual Market—WCRIBMA @ 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD The Commonwealth of Massachusetts Department of Industrial Accidents -- - Office of Investigations _ 600 Washington Street Boston, MA 02111 _ www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information. Please Print Legibly Name (Business/Organization/Individual): CAPIZZI HOME IMPROVEMENT INC Address: 1645 NEWTOWN ROAD City/State/Zip: COTUIT , MA 02635 Phone #: 508-428-9518 Are you an employer? Check the appropriate.box: Type of project(required): 1. ✓ I am a employer with 40+ 4. I•am a general contractor and I employees (full and/or part-time).* have hired the sub-contractors 6. New construction 2. 1 am a sole proprietor or partner- listed on the attached sheet. 7. Remodeling ship and have no employees These sub-contractors have g. Demolition working for me in any capacity. employees and have workers' 9. Building addition [No workers' comp. insurance comp. insurance.#. required.] 5. We are a corporation and its 10. Electrical repairs or additions 3. I am a homeowner doing all work officers have exercised their 11. tubing repairs or additions myself. [No workers' comp. right of exemption per MGL 1 Roof repairs insurance required.] t c. 152, §1(4), and we have no employees. [No workers' 13. Other comp. insurance required.] Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: AMGUARD INSURANCE COMPANY Z0 Policy#or Self-ins.Lic.#: R2WC52 Expiration Date: 12/25/2017 Job Site Address: l` Z Gl-e /� City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify er the dpenalties ofperjury that the information provided above is true and correct. SigLiature: Dater Phone#: 508-428-9518 Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector<5.Plumbing Inspector 6. Other Contact Person: Phone#: e ' Information and Instructions �. Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute, an employee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual,partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the g gJ IP � g g p receiver or trustee of an individual partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary, supply sub-contractor(s)name(s), address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships (LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' -compensation policy, please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must'submit multiple permit/license applications in any given year,,need only,submit one,affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. Anew affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.).said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's addfess,telephone and fax number: ' The Commonwealth of Massachusetts Department of Industrial Accidents Office of Tnvestigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax# 617-727-7749 Revised 4-24-07 �I www.mass.gov/dia Engineering,Dept.(3rd floor) Map Parcel p ermit# House# Date Issued 3,0 `1(r Board of Health(3rd floor)(8:15 -9:30/1:00-4:30) Q = Conservation Office(4th floor)(8:30-9:30/ 1:00-2:00) ® SYST F BE F e y annmg oar 19 i ®�'G ALLpEypD@IN � CE WITH LE. ENV ` ONMEN AND TOWN OF BARNSTABL WIN �, EGUL �r Building Permit Application ProjecPeetdress /, _l��,�j�-! < j�Cc. Village Owner ,Cps,Si5�i� Address Telephone -SZZS.,y Permit Request /z y2 fr" . ,rWC:a� 8'X/z` &V- c,f!>� First Floor square feet Second Floor square feet Construction Type -70 Z---y,4AZZ^16- Estimated Project Cost $ Zoning District _ �I Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family Wr Two Family ❑ Multi-Family(#units) Age of Existing Structure Historic House ❑Yes Ulo On Old King's Highway ❑Yes IWo Basement Type: 21fru11 ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) Number of Baths: Full: Existing New Half: Existing New No. of Bedrooms: Existing '-- New Total Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: ❑Gas ❑Oil ❑Electric ❑Other Central Air ❑Yes ❑No Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No GarlF ❑Detached(size) AldtJ&— Other Detached Structures: ❑Pool(size) ❑Attached(size) ❑Barn(size) ❑None ❑Shed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial.-t Yes ❑No If yes, site plan review# Current Use Proposed Use Builder Information Name 6 Telephone Number Address G &,W License# e '°7a,3 Z am2S,l --, j>7 Home Improvement Contractor#I y 7K-9 Worker's Compensation#D�tcr cQ1 51 . NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE R DATE Z1�2 BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) . 3 FOR OFFICIAL USE ONLY 4 PERMIT NO. DATE ISSUED I, MAP/PARCEL NO. ADDRESS t VILLAGE•, OWNER DATE OF INSPECTION: FOUNDATION I L FRAME INSULATION FIREPLACE ELECTRICAL: ROUGH FINAL PLUMBING: ROUGH FINAL GAS: ='?ROUGH FINAL FINAL BUILDINE� DATE CLOSED qyT ASSOCIATION PLAN NO. A ASSESSORS MAP 169; PARCEL 46 .LOT 34 LOT 33 LOT 32 100.00' 82.3' 00 10.3 LOT 29 0 0 28.D' o ,2 29.6' 39.3' 100.00' LIETRIM CIRCLE Ref: Plan Book 223; Page 139 /GIST to r7 2 12/28/95 1 ADD NOTES SAW 1 12 27 95 INITIAL ISSUE CHK THIS PLAN IS NEITHER INTENDED N0.1 DATE I DESCRIPTION BY FOR, NOR SHALL IT BE USED FOR EXISTING CONDITIONS PLAN MORTGAGE LOAN PURPOSES. 112 LIETRIM CIRCLE CENTERVILLE, .MASSACHUSETTS FOR Lois L White c SCALE: 1" = 40' JOB NO. 1790/1790ASB.DWG I CERTIFY THAT THE HOUSE a�° PA1.R. r� SHOWN ON %TE-RqD LOC D �_ 0 40 80 ON HE GRO _ Me. 10117 � J r * LEVY, ELDREDGE & WAGNER ASSOCIATES INC. ATE RD SURVEYOR ENGUM LINDSCAPE ARCHPI17CfS PUflNERB 1A SURVEYORS 586 STRAWBERRY IML ROAD CENTERVIUZ MA. 02632 I'T1 = X vI Iz-1 U� RIDGE VENT 1"x 6" COLLAR TIES H TYPICAL ROOF CONSTRUCTION; �_-_ �iTC ASPHALT ROOF SHINGLES; 15# FELT PA 1/2" CDX PLYWOOD SHEATHING; 2"X 6" RAFTERS AT 16" O.C. -- 2"x it ® 16" O.C. TYPICAL EXTERIOR WALL CONSTRUC GARAGE WHITE CEDAR SHINGLES AT 5 TO SIDES & END ELEVATIONS; T-8 1/2' H H G "TYVEICOR EQUAL BUILDING PAPER 1/2" PLYWOOD SHEATHING; 2"x 4 STUDS AT 16" O.C. 5" CONCRETE SLAB 2 x 6 TREATED SILL 6'- 8' GRADING 4' � Ila 8" CONCRETE WALL 16" x B" CONT. CONC. FOOTING r, RIDGE VENT TYPICAL TYPICAL ROOF CONSTRUCTION: 1"x 6" C R TIES .4 PITCH ASPHALT ROOF SHINGLES; 15# FELT PAPER; IZ 1/2" CDX PLYWOOD SHEATHING; R30 INSULATIO 2"X 8" RAFTERS AT 16" O.C. TYPICAL �s 2"x 8" ® 16" O.C.— VENTED SOFFIT OR DRIP EDG 02Xg � ' TYPICAL EXTERIOR WALL CONSTRUCTION. / WHITE CEDAR SHINGLES AT 5" TO WEATHER SIDES do END ELEVATIONS; BREEZEWAY PORCH �.�-� �x 6 "TYVEK"OR EQUAL BUILDING PAPER; �aC 1/2" PLYWOOD SHEATHING; 2"x 4" STUDS AT 16" O.C. />'nC ? !� F1/lfrj R11 INSULATION, TYPICAL 5/8" CDX PLYWOOD 5/4" DECK RAIL R19 INSULATION, TYPICAL SUB-FLOOR 2"x 10" ® 16" O.C. 2"x 6" TREATED SILL GRADE C R O 1/2" CDX PLYWOOD- S 8" CONCRETE WALL 4' 16" x 8" CONT. CONC. FOOTING • Im 1645 Newtown (508) 428-951 1__R 4'-0' BULKHEAD 12' x 18' ADDITION 3' WIDE 16' HIGH DECK STEEL DOOR DH WINDOW�� 3' WIDE 6' DUAL PAIN DH WINDOW 12' x 24' STEEL DOOR GLASS SLDE DOOR ONE CAR GARAGE 7'-6'x 12' — — --1 BREAZWWAY E R I 7'-6'x 4' DH WINDOW OVERHANG FARMER'S PORCH 9' WIDE GARAGE DOOR �i(7 VlNcloal EXISTING HOUSE APPROX TO SCALE 10/221 996 13: 36 508-759-7395 WIGGIN PRECAST CORP PAGE 02 WIGGIN PRECAST CORPC.)RATION P.O, BOX 1138 . POCASSET, MASSACHUSERS 02559 Phone (508) 759-6774 • 1 (800) 564-6774 . Fax (508) 759-7395 * CONTRACTORS TAKE 10% OFF LISTED PRICES * prices shown. include Silco doors f CW awary had".1 $805 .00 $810 .00 $820 .00 $850 .0012; $995.00 Tvp c S Typo O T"_8 Type-C T'1pe•Q _ � eau,. 19 112 n 3 t+ T74" 45" 60t' 68" I+ bt b"WtDiH St!h"WIDTH 69V."WIDTH �' ��"w10Ti} 651+"tNIDTM . OUTSIDE 0117$IP£ CUTStDE OUTSIDE DUT$IOF DIMENSION DIMENSION DIMENSION DIMENG" DIINftNFfON IWO— FINISHED 13ASEMENT FLOOR LINE 2" ABOVE SASE OF CASTING COMPLETE OUTS= EDP, BASEMENT ENTRANCE iArWAY DURABLE AND ECONOMICAL 1 . Steel reinforced concrete sub-grade. un 2 . Positive seal proved by 5 decades of field c:�xperience. 3 . Rugged stet--,1 dual-leaf doors solidly secUred to water shedding sills. 4 . Finest quaiity seals and caulking used (_taro;.:<:Z Ali o tit . JOB REQUIREMENTS 1 . Foundation wall opening 40" wide maximum all sixes . 2 . Adequate access for delivery truck. ( solid ground surface conditions ) 3 . Ensure proper soil drainage at base of unit using gravel. 4 . Stairwell should be 2" to 6" above finished grade . •: - 2 $kttrSTpl G i� • .. � yxG PT sr ' 46 r oc • �`nfFCa�o•t4fl ` y �✓L _ alo3 'Alh A? /�is C l.�S�.�ahttr,Irt'J 07*Mrl+ r ,• t .. y�)��s�Jtts�a-van-� /ZVIOOP ✓� 'G'tJ�=ice - � •�- ;��-ice. ,: i 4'-0' BULKHEAD 12' x 18' ADDITION 3' WIDE 16' HIGH DECK STEEL DOOR DH WINDOWe�*� 3' WIDE 6' DUAL PAIN DH WINDOW 12' x 24' STEEL DOOR GLASS SLDE DOOR ONE CAR --� GARAGE T 104 -6'x 12' f— — BREAZWWAY YYY �� 1) E i 7'-6'x 4' DH WINDOW OVERHANG FARMER'S PORCH L— — — 9' WIDE �- GARAGE DOOR J� �X� ViwdcaJ �� EXISTING HOUSE APPROX TO SCALE FLOOR SCALE:1, } . t G �P I Hon. Improve Inc. 1645 Newtown Rd (508) 428-9518 Fa: H v•�.��lst 3�3 r a4 a #. �' �� ,, ��' h� .t � A., - r� tit• •(, y i � {k Hl f ILI The Commonwealth of,llacsac'husctts Dc• arfinent of IndustrialAcc'idents Office allayestigativns �rr 6(Ib washing Strict Boston,Alas. 02111 Workers' Compensation insurance Affidavit A ltcan [nf rmation: PI'ace PR 1�i�l r�__._ a 7,. nam : location cih phone# I am a homeowner performing all work myself. 1 am a sole proprietor and have no one working in any capacity L.i•l 1-�_..w=..•rr..rb��_.].L'a.LLawiiffif.•._.:`_ti .�- ''�1..L... .Sr��.+ - Cair�.�:r._2�_:..._. ' I am an employer providing workers' compensation for my employees working on this,lob comonnv nantc: address: phnne#: insurance co. pnlicv# if ld!5:n w !�Os .._...... ..R..y:.r.•.-,,.-w,..._...,r_;e;t^^.r`'-.n^•.�er.:- „•f,_•r-••+.-+-�3 <. �-ss.+r^.++e+.-.. ...�.-..-.a�.z.;..�—•�'�,-;++.+�-r-;'je'.;'_r•. ❑ I am a sole proprietor,general contractor,or homeowner(circle one) and hav:hired the contractors listed below who have the following workers' compensation polices: company name: address: cih•• phone#: insurance co police# ..-...---_..�.._a.._....r::Y.._.- -rri.S �Y^1...t-p"1 -� _ ..r... �_�.�. \:.� .• _ _• - -i:�rx,-.+Y _ -_.,t.. -y-_ _......v.. _Ll-_.... :uti:iv.�-.11�._....l:..S- ^i:C1:L•s1.JSF'.Y.l w:• -h..�!��ld�_:� iS:.`�.aixLaY> "L::.:•'�i.•• �u:cy_ c(Impanv name- address: cih•• phone M. insurance co nolicv# `�ttncb a_ddt _ tl0nal sheet If nCCCSSa ..x:....:rc-..:., e,,., tc.�`�.�aiScke'�.•.;�r�,::..:�v.'.�¢�g•�;•'-f �'=.:n �<. .� - :• ., y.,c» ._ - .:,�• Failure to secure coverage as required under Section 25A of i\1GL 152 can lead to the imposition c'f criminal penalties ora fine up to SI 500.00 and/or one)-cars'imprisonment as hell as civil penalties in the form ora STOP 11.ORK ORDER and n rite of S100.00 a day against me. I understand[fiat a copy of this statement may be forwarded to the Office of Investigations orthe DIA for coverage vc-ification. I do hereht•certift•t rter pans aid pe !ties ofperjury that the injorn»ation provided a3ove is trite and correct. 3 SiEmaturc `% t Date 01 61 �� - 7 gs-!� Print name /"C ' ��—er �:�one# � •-- . use only do not write in this area to he completed by city or town official offi .;. eit or town: permitfliccnsc# rlt3uilding Department k<• oLiccnsing Board is ❑check if immediate response is required OSclectmen's Office . ollealth Department �contact person: phone#: r•IOther _ �-..-...__...r..�-www.`.._nr... _ .�--T��f!•,Z!.e;.�'�T^l�lT1r,�CS�C-�C+^jam-'r�.��a'^•T^.L -lta�..w._-.e..w�...r+.erw�1!'�. The Town of Barns tab t Department of Health Safety and Environmental Serve Building Division 367 Main Street,HYaaais MA 02601 - Ralph C:omen OTI= 508-790-6= $stag Commisnonc Fear 308-775-3344 r For office use only permit no. Date AFFMAVTr NTRACrORLAW HOME SIIPPLEMENT�PERMIT O APPLICATION •nxonstinctian,alto V1=s,teaovadoa,repair, ° c ' MGL c 142A requires that theaonrr 00,*,d irrnprcVc:nc t,.remotia m l. demolition. or aonsnas of an addition to-any pee-u� ��are . building containing at least one but not more than four dwelling with other to such residence or building be done by registered coatrz=rs.with �i° . °ns' along 'Type of Work: Est. Cost f 3 Address of Work: Oa ner.Name: i� •`9 Date of Permit Application: I hereb<certify that: i Registration is not required for the following rrasou(s): I work ccduded by law —Job under st cop Building not awner-docaFied - Owner pulling wn Pcr=t Notice is hereby given that: RS OWNERS PULLING'THEIR OWN PERMIT OR DEALING wt1TF DRFtEGISTEM CCESS ,ro�' VOR APPLICABLE HOME DaROVEMENT WORK DO NOT HA ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c 142A SIGNED QNDER PENALTMS OF PER.iURY I hereby apply for a permit as the agent of the owner: tegistcati= No. Date name OR ' Engineering;Dept. (3rd floor) Map 'Parcel O 6 ad Permit# a(ID • T House# Date Issued Fs�lkj9'7 Board of Health(3rd floor)-(8:15 -9:30/1:00-4:30) �'1 `� � ��'� Fee �� Conservation Office(4th floor)(8:30-9:30/1:00-2:00) Sri` Planning De (1st floor/School Admin. Bldg.) �/�/V Ft e�®k$�+ g+'1 Defim i e P pproved by Planning Board 19 TOWN OF BARNSTABLE _. ®AID D Building Permit Application / Project Street Address l/ 4P jl�! Gid e— aiU/Pe0Z1C_ Village GA71;ev/Le Owner d f S Address Telephone sb b-- g —.S Permit Request New A00 First Floor square feet Second Floor square feet Construction Type 6/0c) Estimated Project Cost $ _ O Z� Zoning,District Flood Plain Water Protection Lot Size Grandfathered ❑Yes ❑No Dwelling Type: Single Family Two Family ❑ Multi-Family(#units) Age of Existing Structure A,5-I— Historic House ❑Yes f On Old King's Highway ❑Yes UR�6- Basement Type: ull ❑Crawl ❑Walkout ❑Other Basement Finished Area(sq.ft.) Basement Unfinished Area(sq.ft) /ZCkp Number of Baths: Full: Existing / New Half: Existing New No.of Bedrooms: Existing 2 New Total Room Count(not including baths): Existing New First Floor Room Count Heat Type and Fuel: Gas ❑Oil ❑Electric ❑Other Central Air ❑Yes l& o Fireplaces: Existing New Existing wood/coal stove ❑Yes ❑No - N Garage: ❑Detached(size) Other Detached Structures: ❑Pool(size) ttached(size) /2X Z0 ❑Barn(size) ❑None erghed(size) ❑Other(size) Zoning Board of Appeals Authorization ❑ Appeal# Recorded❑ Commercial ❑Yes 9<0 If yes, site plan review# - Current Use Proposed Use �� Builder Information Name zzs-we J �e� 0a/ Telephone Number Address �T OCtJ6.p��ge %7iQ��j _ License# CS 05F-36 V �cv /Y// Home Improvement Contractor# m/gso Worker's Compensation# NEW CONSTRUCTION OR ADDITIONS REQUIRE A SITE PLAN(AS BUILT)SHOWING EXISTING,AS WELL AS PROPOSED STRUCTURES ON THE LOT. ALL CONSTRUCTION DEBRIS RESULTING FROM THIS PROJECT WILL BE TAKEN TO SIGNATURE �v ( G�21 DATE l� BUILDING PERMIT DENIED FOR THE FOLLOWING REASON(S) FOR OFFICIAL USE ONLY PERMIT NO. t - " DATE ISSUED t ' MAP/PARCEL NO. ADDRESS - - VILLAGE OWNER r DATE OF INSPECTION: FOUNDATION- ' FRAME INSULATION ` _ ff l FIREPLACE ). r. ( 7.. ELECTRICAL: ROUGH - FINAL PLUMBING: ROUGH .` ' FINAL ` GAS: ROUGH FINAL _ FINAL BUILDING,* �'' t,i V` r ��= ✓1 DATE CLOSED:OUT, ASSOCIATION PLAN NC(� . a The Town of Barnstable e�vsreacE. MAM �0 Department of Health Safety and Environmental Services Building Division 367 Main Street,Hyannis MA 02601 Office: 508-790-6227 Ralph Crossen Fax: 508-790-6230 Building Commissioner For office use only Permit no. Date tf/W- l� AFFIDAVIT HOME IMPROVEMENT CONTRACTOR LAW SUPPLEMENT TO PERMIT APPLICATION MGL c. 142A requires that the "reconstruction, alterations, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at.least one but not more than four dwelling units or to structures which are adjacent to such residence or building be done by registered contractors, with certain exceptions,along with other requirements. ��ff � Type of Work: /UQLI Aw Est.Cost Address of Work: / 11/irI (fZXCA' 11,12 p Owner's Name /U/S 441, le- Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): Work excluded by law Job under$1,000. Building not owner-occupied Owner pulling own permit Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A SIGNED UNDER PENALTIES OF PERJURY I hereby apply for a permit as the agent of the owner: CS fZ 911 Date Contractor Name Registration No. OR Date Owner's Name The Commonwealth of Afassac h usetts -•-. :_ Dc partnunt of Industrial Accidents F Office OfInvesM.7110ns �i,\_,'•.'; =r :�'` 600 11'ayNti rots Street �''. Boston, A1u.u. 02111 Workers' Compensation Insurance Affidavit Apnitcant information: Please PR(NT lebj� name: location S'� �l�w✓�/UCi� �� I Yt city `,xi- *xDc;—/h nhonc ti J`�&—59 5{—S l 6 I am a homeowner performing all work myself. �1 am a sole proprietor and have no one working in any capacity _•.... .w...., e.....,-,.......,.,w...-..n.rvr.'�.ssxT„KT•�wM?+,I.7F.!.".:.A�+*...'1+.++"�!!+,T!".�s......w.�.�ww... ....a .�...r......._..�...."n._�-...._.. ... I am an emplover/Wlj vidinL kers wor ' compensation for my employees working on this job. ta cons nv narne: 7/,14 ARC address: l t ip( al• . city: DMC'/ees nhonc#: 50b--"77�1- insurance co. &WW C S U,4% 1 SC 3OOI5 0? r-1 I am a sole proprietor. general contractor, or homeowner(circle one) and have hired the contractors listed below who have the followin! workers' compensation polices: company natnc- address• city: nhonc#- insurance co. policy# .rr.Jr - - l:-iiO�Y•• cmmram' name: address: rite: phone#- insurance,co. policy# Attach additional sheet if necessary =• + - +�' —~ �"v '^ ,` - "—^�' '-- __ .. .«.. u:ZS%' ��- ••�� `-••'1,iW_- `_ `-�:T"-_ ilY!'�.L�-i!•.lNci:�i►L Failure to secure coverage as required under Section 35A of NIGL 152 can lead to the imposition of criminal penalties of a tine up to S1.500.00 andiur une years' imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me,. 1 understand that a copy of this statement mac be forwarded to the Office of Investigations of the DIA for coverage verification. I do herehr cerrifr under the pains and penalties of perjurt•that the information prorided above is true and correct. Si_naturc ,yGit Datc S//7 Print name �a4lftl'?V /� �el�.�.PJatJ Phone# -50S_39X S//6 official use only do not write in this area to be completed by city or town official r+ city or town: permit/license# RBuilding Department C)Liccnsing Board I]check if immediate response is required Selectmen's Orricef. [311calth Department contact person: phone#: r other s r. re.,sea 3, ptA information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for the;, employees. As quoted from the "law an emplitree is defined as every person in the set of anc�thcr under an.' contract of hire, express or implied. oral or written. An emplorer is defined as an individual, partnership, association. corporation or other legal entity, or anv two or more the foregoing engaged in a-joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual , partnership. association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein. or the occupant of the dwelling house of another who employs persons to do maintenance , construction or repair work on such dwelling hou, or on the Grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that e,%•en•state or local licensing agency shall withhold the issuance or rene��al of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally. neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter hZ been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names. address and phone numbers as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested. not the Department of Industrial Accidents. Should you have anv questions regarding the "law'' or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of \the affidavit for you to fill out in the event the Office of Investigations has to contact you re=arding the applicant. Plea 'be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned t the Department by mail or FAX unless other arran`ements have been made. The Office of Investi=ations would like to thank you in advance for you cooperation and should you have any question please do not hesitate to uive us a call. . Tile Department's address. telephone and fax number: The Commonwealth Of Massachusetts Department of Industrial Accidents Office of investigations -µ 600 Washington Street Boston, Ma. 02111 fax #: (617) 727-7749 phone #: (617) 727-4900 ext. 406, 409 or 375 :i"`i o./ .. s + �rr4 �ro i? 3 _*"i rt d 'd� k [. i {*y �^'» �• �4 ,av} Fu i F f V.zf h I� f.l b g 1 6 /26 /97 w L +' r,rit � J.E .i CL;t Cr I v�;In;aC,OIJ 1'TC :� ✓ ... �AS i L,� C. :'S NO Fr,(aHTS UPON THE CERTIFICAI ` 10LD 7iilo C Cltl`iFiCATE DOES NOT AMEND, EXTEND 0 i COVERAGE AFFORDED BY THE POLICIES BELOW. *, I ! t t is.•,w ... .,L;)•.,,e.�': z Y COMPANIES AFFORDING COVERAGE sV1 rl 1 2 33 COMPANY r • Y. —' ; ,•. ''' A MARYLAND CASUALTY S„ , J Y ,� i COMPANY Jti •.K0NiA U° Df? ....-_ .COMPANY �h F r UTN � tV A W273 C ,. COMPANY D r At3 t u O CL`,1I,Y ,,,rT 71 ii.POLICIES Or INSURANCE LISTED BELOW'HAVE-BEEN ISSUED 0-THE-INSURE ABOVE`FOr�THE POLICY PERIOD �j ItdD i ;"fED, N0' I IqS AND',NG ANY REOUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTiFI A'I E P-lAY C5 ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, e,TE iCLU``.IONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. - C0 s °TYPE Cr lti -.�-„rCE POLICY iJUMBER POLICY EFFECTIVE I POLICY EXPIRATION I LIMITS Lll� - . . _ '� °- DATE(MWDD/YY) DATE(MWDDNY) z C R.,L-UADILITY. I GENERAL AGGREGATE X COt:✓-FICIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG s 2 0 0 0 0 0 0 P t' CLAIMS MADE X OCCUR a PERSONAL 8 ADV INJURY I S 10 0 0 0 0 0 q 0%WNER'S a CONTRACTORS PROT S C P 3 0 015 4 0 9 0 9/3 0/9 6 .0 9/3 0/9 7 EACH OCCURRENCE 1 S 10 0 0 0 0 0 } I FIRE DAMAGE(Any one fire) I S 3 0 0 0 0 0 w I MED EXP(Any one person) �s AUTOFAODILE LIABILITY. i ANY AUTO COMBINED SINGLE LIMIT I:S ALL OWNED AUTOS BODILY INJURY S SCHEDULED AUTOS (Per person) j HIRED AUTOS. BODILY INJURY r L,., • NON-OWNED AUTOS (Per accident) S PROPERTY DAMAGE S * : GA(IACE LIABILITY AUTO ONLY-EA ACCIDENT I S ANY AUTO I OTHER THAN AUTO ONLY r a � _ EACH ACCIDENT S AGGREGATE ! : { EXCESS LIABILITY. - .' EACH OCCURRENCE s UMBRELLA FORM [ � AGGREGATE "+ OTHER THAN UMBRELLA FORM WORKERS COMPENSATION AND VJC STATU• ( fti EMPLOYERS'LIABILITY - T RY LIMITS I I L_q THE PROPRIETOR/ I �I EL EACH ACCIDENT PARTNERS/EXECUTIVE ItJCL EL DISEASE•POLICY LII,41T OFFICERS ARE: n EXCL EL DISEASE•EA EMPLOYCr OTHER I ------- DES CRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS CARPENTRY } �}.^i— a E f :r, a. tom{Nvi, ' •t4 Fe f t '� � � Sir:' , - ✓ THE TOWN OF BARNSTABLE BARNSTABLE. NAG& ,61& 39* BUILDING INSPECTOR 0 e 74 APPLICATION FOR PERMIT TO .... .. . .. . 0 op0 ..... ...... .. . TYPE OF CONSiCONSTRUCTION .... .... ........................ ..... . ............. ............. ............. ........ ...a�................................19.27 TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies. fo a permit according tot folilowing information: .. ....... . Location ... ........ ..............( ProposedUse -<I 1.410N,... . .... ................... ... ..................................................................................................................... Zoning District ........ .....................Fire District ... 1.71................................. ..............7 ............................. Name of Owner ........ Address ..j........................... f, /1 7........... Name of Builder ....................................................................Address Name of Architect ..................................................................Address e- Number of Rooms .... .................................................Foundation .... .......... ............................ Exterior ....&..)...-.Z. .t........ Roofing �14 .. ... ...... ...... --- ................ ......................... Floorsk .........................................................................Interior ................................................ Heating4 ......t.... . ............................................Plumbing ............ ................................................................... Fireplace ............1......................I..............................................Approximate Cost ....... Difinitive Plan Approved by Planning Board .------------------------------19-------- 90 - Diagram of Lot and Building with Dimensions ?moo YY\ LIJ. 0 (J) jL -.4 UJ "Z L!,j t7L C) CD 0 < CZ� 0 0 0 < 0 0 CL LLJ �2 I hereby agree to conform to all the Rules and Regulations of the Town of B rnstable regar ing the above construction. N ............ ..... .. ................ ................................ Dacey TqIIieoo E. Jr. � . DEC . ��/ _.~� "� ^ '�" » - ' - , No —. Permit for --ooa story,--- � � . --- ' ' . le .---��'..��...��.------. Lietario Circle ' Location --'-----......------------' � . Centerville . —~--.----.--.----^--_-------. Owner .............WlIIi.ao..E...I�aceyv...Jr._._ �Type of Construction ...........frame.................... . ^ —'—'--'^—'-~'--'---------''^----''' ' Plot ........................ Lot ............��*�xxa ............. ^> - ' Permit Granted ...... j........ ..... V 71 . Date of Inspection — CJIT. x.)----lA 7) \ ' Date Como|e�e6 -----.-------]g . \ ' ' ` | PERMIT REFUSED � , ----...----.---.--.--.-----. lA | ^. '~- - '----'---'--~-------------'--'`' | � —.—,---'-_.._--.---..--..—.---.---. . � ' ^—''-'--^^'----~^^'—^---'^^--~----' ,..—....—.-.--~.--~...,...,.—_......._. - . ,,r-.-- ~ lg ---------.—.----' | ' � ^ / —'-----'—'------^^^^^^`--^^^---' ' ^ � ----.---.--....---------,.,—...-